My family and I are off to Mexico for a vacation. We are staying at the same hotel we usually do, but this time I am bringing something new – an EpiPen.

It was at this hotel where we had the “cashew incident.” Months before, my daughter had tested positive to cashews (and other things) on a food allergy skin-prick test, but she had never eaten one, and to this day never has. At the hotel bar they routinely put out chips and salsa and a big bowl of mixed nuts. My daughter knew to stay away from the nut bowl, and I kept it out of her reach, but beyond that I didn’t think much about it.

A little while later, she started scratching her face around her lips. It was a bit dark so I didn’t think anything was serious, until she said to me “Mommy, my lips hurt.” I focused my eyes on her lips and saw that they were swollen. In an instant I scooped her up and went running to our hotel room where I had a bottle of Benadryl. I called my dad, who is a pediatrician, in a panic. I gave her the Benadryl and waited for her symptoms of food allergy to subside. It worked. Within a half an hour she was as good as new (and a little high off the Benadryl).

I was relieved and confused – what set off this allergic reaction? When did she eat a cashew, or maybe there was something else she was reacting to, but she had not eaten anything that she hadn’t had before. I voiced my confusion to my in-laws who had joined us on the vacation. It was my father-in-law who volunteered that he had been playing a game with my daughter where she would bring him a tortilla chip and he would give her a little kiss. In addition to the chips, he had been eating from the nut bowl – and picking out the cashews in particular. Wow… wow. I was a little stunned – she had a reaction to cashews via a kiss.

I had heard of the peanut-kissing story back in November of 2005, where a Canadian girl died after kissing her boyfriend who had eaten peanut butter 9 hours before. Months later, the coroner said that she did not die from an allergic reaction to peanuts, but by then the case had already received so much media attention that nobody knew this conclusion to the story. What did come out of this news was that a study was done on peanut allergens in saliva. It concluded that peanut is detectable in saliva right after eating a meal with peanuts, but that it leaves the saliva after several hours. In other words, don’t kiss someone who has just eaten the thing you are allergic to!

When I told the pediatric allergist of the incident, he asked “Did she have any trouble breathing?” “No.” “Did she have any drop in blood pressure” “No.” He concluded that she did not have an anaphylactic reaction and therefore probably does not need an EpiPen. That made me feel better, but then I thought – if she had that reaction just from a little contact, what would happen if she actually ate a cashew?? My daughter’s pediatrician and my dad agreed with me and felt it was better to be safe than… well, you know.

So off we go to Mexico with an EpiPen. It makes me nervous to have it, but nervous not to.